12.3.1 Drugs for oral ulceration and inflammation
Oral ulceration may be treated with corticosteroids.
|
| |
New advice on oral salicylate gels in under 16s from the MHRA
|
The main products affected are Bonjela® and Bonjela® Cool Mint Gel.
|
The new advice recommends that these products should not be used in those under 16 years of age. This is due to salicylate salts having the same effect on the body as aspirin which is already contraindicated in children and young people under 16 years of age.
|
| |
GREEN Bonjela® oral gel
|
GREEN Hydrocortisone pellets 2.5mg
|
AMBER Gelclair® - only for acute chemotherapy/radiation induced mucositis
|
AMBER Betamethasone 500 microgram soluble tablets
|
| This product is used in oral surgery practice only: dissolved in water and used as a mouthwash |
| |
Treatment of inflammatory conditions
|
GREEN Benzydamine (Difflam®)
|
| oral rinse 0.15%, spray 0.15% |
| |
12.3.2 Oropharyngeal anti-infective drugs |
The most common cause of a sore throat is a viral infection which will not benefit from anti-infective treatment.
|
Chlorhexidine mouthwash renders nystatin ineffective, therefore wait 15-30 minutes before applying nystatin.
|
| |
Fungal infections
|
First line:
|
GREEN Miconazole oral gel 24mg/mL
|
| |
Prescribers are reminded that there is a significant interaction between warfarin and miconazole -including the oral gel,
|
resulting in an increased INR. This product should therefore be avoided in patients taking warfarin.
|
| |
Second line or for infants under 4 months or patients taking warfarin:
|
GREEN Nystatin
|
| suspension 100,000 units/mlL |
| pastilles 100,000 units |
12.3.3 Lozenges and sprays
There is no convincing evidence that antiseptic lozenges have a beneficial action and they sometimes irritate and cause
|
sore tongue and sore lips. Some of these preparations also contain local anaesthetics which relieve pain but may cause
|
sensitisation. The following products are stocked within the hospitals for symptom relief only but are not generally
|
recommended for prescribing.
|
| |
| RED Dequadin® lozenges |
12.3.4 Mouth-washes, gargles, and dentifrices
For use if a patient has, or is at risk of, an oral infection. Chlorhexidine inhibits the formation of plaque and may be
|
useful when tooth-brushing is not possible. (see ELHT Mouth Care Policy May 2003)
|
| |
GREEN Chlorhexidine mouth wash 0.2%
|
| GREEN Chlorhexidine oral gel 1% |
12.3.5 Treatment of dry mouth
Endorse prescription with ‘ACBS’ – patients suffering from dry mouth as a result of having (or having undergone) radiotherapy, or sicca syndrome, apply to gums and tongue as required.
